How to manage co-morbidity, CVD prevention, risk assessment

01 Sep 2007

Dr. Ulf Georg Dahlstrom,
FESC

Prof. L. Rydén spoke about diabetes. He presented the newly published European guidelines on diabetes and showed that the prevalence of diabetes is increasing rapidly. He also declared that if we treat our patients properly with statins, ACE inhibitors or ARB and aspirin, we dramatically improve the outcome in patients with diabetes.

Topic(s):

Prevention

Why are comorbidities important?

Next, Dr Isabelle Van Gender spoke about atrial fibrillation. She showed that the prevalence was increasing and that more than 20% of all strokes were due to atrial fibrillation. Optimised treatment of patients with heart failure through use of ACE inhibitors or ARBs or Beta-blockers resulted in a decrease of atrial fibrillation. In patients with heart failure, it is better to aim to have rate control instead of rhythm control.

Prof. Tavazzi moved on to speak about ischemia. He showed data from the Italian survey on patients with acute heart failure, showing that the outcome was worse in patients with an ischemic etiology compared to a non-ischemic etiology. He also declared that in the guidelines there was no clear indication as to when it was recommended to perform a revascularization in patients with ischemic heart failure.

Dr Gustafsson closed the session by discussing chronic obstructive pulmonary disease (COPD). COPD is not looked after in patients with heart failure, thus as they are heavily under-diagnosed, patients with COPD and heart failure do not receive recommended therapy with beta-blockers, although not contraindicated. Spirometry must be performed more frequently when evaluating patients with heart failure.

Conclusion:

Comorbidities are important to consider when managing patients with cardiovascular diseases.

References

3117-3120

SessionTitle:

How to manage co-morbidity Clinical Seminar

The content of this article reflects the personal opinion of the author/s and is not necessarily the official position of the European Society of Cardiology.